Depression is common among young Nigerians. It shows up as physical symptoms and falling grades instead of sadness and can go untreated for years.
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Depression is one of the leading causes of disability in the world. It is a mood disorder, and it changes how a person gets through an ordinary day.
It is common in young people, but it looks different in them, so it often goes unnoticed for a long time. It can start as sadness that lingers, restlessness, trouble concentrating, losing interest in things that used to be enjoyable, hopelessness, or tiring easily. Severe depression can bring thoughts of suicide, which is why getting help early matters.
Nigeria's national survey, with fieldwork in 2002, found major depression in 3.1 per cent of adults at some point in life and in 1.1 per cent in the previous year.
Put simply, about one adult in every hundred had it last year. About three in every hundred will have it at some point.
That survey is old. The real figures today are almost certainly higher.
For young Nigerians, a study of 1,206 university students used a full diagnostic interview and found:
Two kinds of study get mixed up here.
A screening questionnaire asks about symptoms. It is built to catch anyone worth a closer look, so it always flags a much larger group than a proper clinical interview would.
An interview with a clinician checks whether the person actually meets the criteria for depression. Those criteria are stated in the International Classification of Diseases.
Both are useful. However, they do not yield the same results. Some of the wildly different figures you see online come from treating a screening result as diagnoses.
The Lagos State Mental Health Survey is the largest recent picture of the state of depression in Nigeria. Researchers screened 11,246 adults at home using questionnaires and found current symptoms of depression in 5.5 per cent and anxiety in 3.5 per cent.
Across Africa, distress commonly shows up as physical symptoms. In Nigeria that often means headaches, tiredness, crawling or burning feelings under the skin and pain with no clear cause.
The Lagos survey found the same. Depression and anxiety symptoms are closely tied to physical ones. Older patients more often describe their mood. Young people more often lead with the body.
So a student who comes to a clinic with headaches and tiredness is checked for malaria, another infection, or anaemia. The conversation rarely reaches their mood, and the depression is missed.
The common words for mental illness in Nigerian languages describe severe, visible disturbance. Terms like 'wèrè', 'ara', and 'hauka' equate mental illness exclusively with public psychosis, vagrancy or even spiritual affliction; a young Nigerian who is sleeping badly, cannot concentrate, and feels hopeless does not match that picture. So they may not recognise their condition as a psychiatric disorder. And if a doctor suggests seeing a psychiatrist, they may refuse, because the word itself sounds like an accusation.
Low energy and withdrawal in a young person may be mistaken for laziness, weakness, or a lack of seriousness. A girl pulling away from her friends and slipping in class is called unserious or told she is 'forming attitude'.
That reading comes from family, from school, and from the young person too. All of it delays help.
In a community study of what Nigerians believe about mental illness, 96.5 percent said people with mental illness are dangerous. Fewer than one in six would keep a friendship with someone who had been mentally ill, for fear of being harmed. In fact, people with mental illness are more often the victims of violence than the cause of it.
So young people weigh their dating prospects, school placements, job opportunities, and the opinions of their neighbours when deciding whether to disclose their mental health struggles. Silence is not irrational when those are the stakes.
Child and adolescent mental health is the thinnest part of an already thin system. Nigeria has fewer than 250 psychiatrists in total, for every age group, and only a fraction of them work specifically with young people.
The Centre for Child and Adolescent Mental Health at the University of Ibadan is Nigeria's flagship. It was founded by Professor Olayinka Omigbodun, whose work on building child mental health services in low-resource settings is a standard reference in the field. There are not many comparable facilities in a country with 112 million children.
In young people, it often shows up as irritability rather than sadness. Common signs:
Two questions separate the two. How long has it lasted, and how much is it getting in the way?
The diagnostic criteria use two weeks as the cut-off. Two weeks or more of symptoms that are there most of the day, nearly every day, and that get in the way of your studying, sleep or relationships, means it is time to seek help.
Talking to someone qualified. Psychological treatment works. A meta-analysis found therapy and medication about equally effective for depression. Calling a helpline is a reasonable place to start and is usually free.
Medication. For moderate or severe depression, antidepressants work. However, they take two to six weeks, and a doctor has to prescribe them. Depression often reaches a point where it needs a doctor and antidepressant medicine. Some kinds of depression need other medicines as well to ease symptoms.
Better sleep. Depression damages sleep, and poor sleep worsens depression. A trial of over 3,700 students showed that when you treat insomnia, depression improves. It works the other way too, and some antidepressants help with both.
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Telling a trusted adult. Only about 9 percent of Nigerians with a disorder get any care. A lot of that gap is because people never told anyone. One trusted adult can get the whole thing moving.
What does not help: being told to pray harder to resolve it, as if every medical problem were a spiritual problem, or being told your generation is soft.
Treat any talk of suicide as an emergency. Not everyone with depression becomes suicidal, but when somebody says it, take it as urgent. It is frightening to hear, so look after yourself too.
Every day, young Nigerians describe tiredness, headaches, falling grades, and irritability. The adults around them hear laziness, phone addiction, or bad character.
The problem is more than young people remaining silent. It is also that the people listening do not know what they should be listening for.
Not uncommon. A diagnostic study of 1,206 Nigerian university students found any depressive disorder in 8.3 per cent and major depressive disorder in 2.7 per cent. Questionnaire studies report higher numbers because a questionnaire counts symptoms and a diagnosis needs an interview.
Speak to a doctor. Two weeks is the line. Low mood or loss of interest that lasts most of the day, nearly every day, for two weeks or more, and that is getting in the way of your studying, sleep or relationships, is worth taking to a professional.
Three reasons. It often appears as headaches, tiredness or pain, so it gets investigated as a physical illness. The everyday words for mental illness describe severe disturbance, so a struggling student does not see themselves in them. And being known as mentally ill carries a real social cost, so many young people say nothing.
No. The evidence on this is clear. Ask directly whether they are thinking about killing themselves, take the answer seriously, do not leave them alone if the risk seems immediate, and help them call a crisis line or get to a hospital.
Yes. Several Nigerian organisations run free confidential helplines. Federal neuropsychiatric hospitals and teaching hospitals with psychiatry departments run outpatient clinics at subsidised rates, and many universities offer counselling through student health services.